Periodontal Dentistry

If we maintain good oral hygiene and have regular professional cleanings and oral examinations, we can keep our natural teeth for life. That involves not only caring for the teeth themselves, but also the gums and tooth-supporting bone. Gum disease, which is a bacterial infection, threatens these supporting tissues. When signs of trouble become apparent, periodontal therapy may be suggested.

Periodontal therapy can take various forms, but the goal is always to restore diseased tissues to health. Gum (periodontal) disease can spread from the gums to the bone that supports the teeth, and may even cause tooth loss in the most severe cases. There are very effective therapies to combat this, ranging from scalings (deep cleanings) that remove plaque and calculus (tartar) from beneath the gum line, to surgical repair of lost gum and bone tissue.

Periodontal therapy includes both surgical and non-surgical techniques to restore health to the tissues that support the teeth (gums and bone) and prevent tooth loss. They include:

Scaling and Root Planing: These deep-cleaning techniques are the best starting point to control gum disease. Plaque and calculus (tartar) are removed from beneath the gum tissues, using hand scalers or ultrasonic instruments.

Gum Grafting: Sometimes it’s necessary to replace areas of lost gum tissue so that tooth roots are adequately protected. This can be accomplished by moving healthy gum tissue from one area of the mouth to where it is needed, or by using laboratory-processed donor tissue.

Periodontal Plastic Surgery: When used to describe surgery, the word “plastic” refers to any reshaping procedure that creates a more pleasing appearance of the gum tissues.

Periodontal Laser Treatment: Removing diseased gum tissue with lasers can offer significant advantages over conventional surgery, such as less discomfort and gum shrinkage.

Crown Lengthening Surgery: This is a surgical procedure in which tooth structure that is covered by gum and bone tissue may need to be exposed either for cosmetic reasons (to make the teeth look longer and the smile less gummy) or to aid in securing a new dental crown.

Dental Implants: Today’s preferred method of tooth replacement is a titanium dental implant, placed into the jawbone during a minor surgical procedure. The implant is then attached to a realistic-looking dental crown that indistinguishable from a natural tooth.

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The Connection Between Oral Health and General Health

What’s the link between diseases of the mouth — like gum disease — and those of the body? They are connected by the body’s natural reaction to harmful stimuli, which we call the inflammatory response. Often characterized by pain, redness and swelling, inflammation is a process by which your immune system responds to damage or disease in your tissues. Inflammation can help the body heal — or, if it becomes chronic, it can lead to more serious problems.

Gum disease (periodontitis), cardiovascular disease (CVD), diabetes and rheumatoid arthritis are all associated with the same type of inflammatory response. Studies have found that moderate to severe periodontitis tends to increase the level of systemic inflammation — a condition that may smolder in the background, awaiting the right conditions to flare into a more serious disease. It has also been shown that the same strains of bacteria that are found in inflamed gum tissue may also appear in the arterial plaques of individuals suffering from CVD.

Since chronic inflammation is a systemic problem, the best way to begin controlling it is via a whole-body approach. Maintaining a healthy weight, getting moderate exercise (and, if you use tobacco, quitting the habit) will help with this. So will bringing untreated inflammatory diseases, such as periodontitis, under control.

Although it’s too early to say that periodontal disease causes heart disease or other systemic conditions, they seem to have a connection. And while medicine and dentistry can’t change genetics, together we can control external factors like excess weight, tobacco use and gum disease. Maintaining good oral hygiene is the best way to avoid periodontal problems. But if problems occur, don’t wait: The sooner you have treatment, the better your chances for controlling gum disease — and perhaps systemic diseases too.

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